Pre-diabetes: a fake disease?

Diabetes, real diabetes, is a health condition that needs to be carefully monitored and controlled. The repercussions of not doing so can be pretty horrific.

However, what the hell is "prediabetes," and does it really mean anything? Is it just a way for the drug companies to make basically healthy people into patients and increase profits? It has to be asked.

The diagnosis of pre-diabetes is bad news for patients and their families, most of whom have no idea about all the drama in the background. But it’s also bad news for society as a whole because of the enormous costs associated with treating millions of people who do not have a medical condition. But for the pharmaceutical and diagnostic industries, it’s a great turn of events — and there’s little doubt that Big Pharma has influenced the lower thresholds that have been put in place.

Health News Review printed this follow-up which contains links to other articles that are exploring the question.

Diabetes is a chronic disease that should be taken seriously, but slightly elevated blood sugar doesn't have the same effects on health as full blown diabetes - and slightly elevated blood sugar levels do not necessarily continue to rise until they hit diabetic levels. Is pre-diabetes simply a conservative approach to diagnosis, or is it just a cynical strategy being used by drug companies to create more customers?

Pre-diabetes is the stick that doctors can use to beat fat people into submission so that said fat people will finally give in and go on that diet, get on that treadmill, have that WLS, or take those pills. It's not something that needs to be medicated in the same way as actual type 2 diabetes. And if you don't have a family history of type 2 diabetes, your chances of that "pre-diabetes" actually turning into full-blown type 2 diabetes are pretty fucking slim. Unless your fasting blood sugar is consistently above 125, you can tell your doctor to shove hir diagnosis of "pre-diabetes" up hir ass.
I'm not sure who is behind the lowering of diagnostic standards, but the only ones who benefit from those lowered standards are the drug companies who get to sell more drugs to more patients who don't really have the diseases yet and might never have them - but their doctors will have them taking pills for the rest of their lives, just in case.

"I'm not sure who is behind the lowering of diagnostic standards, but the only ones who benefit from those lowered standards are the drug companies who get to sell more drugs to more patients who don't really have the diseases yet and might never have them - but their doctors will have them taking pills for the rest of their lives, just in case."

Don't forget the campaigners / 'activists' / general busybodies, who can point to the manufactured overnight epidemics of 'obesity' / diabetes / hypertension / whatever as evidence for the need to 'Just Do Something' (TM) and in doing so attract publicity, grants and all the rest. Or the media, who love nothing better than a pariah group, a National Crisis, or a moral crusade, and with public health panics get a prime target for their daily Two Minutes' Hate to package and sell to their readership. Or even the Government of the day, who irrespective of party or ideological bent are perennially seeking a suitable means of distracting the populace from their cronyism, corruption and incompetence.

In fact probably the only people who DON'T benefit from the lowering of diagnostic criteria are those pathologised (and more often than not subsequently demonised) as a result. But at least we can rest easy in the knowledge that our oppression serves a wider social function (/sarcasm).

"What is right is not always popular and what is popular is not always right" - Albert Einstein

The American Diabetes Association (ADA), which in my opinion, is often eager to jump upon every new scare tactiic could only cite one study that showed there was an association between "pre-diabetes" and development of Type 2 diabetes. In that study, 11% of those "diagnosed" with pre-diabetes went on to develop Type 2 three years later. Not a great study, but nonetheless, it indicates that (a) there is no long term research to show that pre-diabetes develops into Type II; and (b) what little short-term research exists, indicates about 90% of people classified as pre-diabetic don't develop Type II. Interestingly, the ADA cautions that one's health insurance may not cover medical expenses related to diagnosis and "treatment" of prediabetes. Hmmm... To me, that is a strong indicator that pre-diabetes is not a legitimate medical condition, much less one needing extra doctor visits, testing, "nutritional counseling," etc.

A family member was convinced she was "pre-diabetic" simply because she had to go to the bathroom during the night. I don't know enough about her health to say that she was or she wasn't. And I'm not even going to broach it with her, because she is convinced a commercial diet she was on that trimmed 20 lbs turned things right around. Again, can't say it didn't. (And it's not my business.)

However, what I can say is that our local head of the diabetes support group (she is a nurse) explicitly says that diabetes is not caused by weight, and the ADA's website backs her up. At least it did when I looked at it.
Per the site, when I looked at it:
Myths:
• Obese and overweight people will eventually develop Type 2 diabetes. Fact: Weight is considered a risk factor for developing the disease, but multiple other risk factors, including genetics, ethnicity and age play a role. "Most overweight people never develop Type 2 diabetes, and many people with Type 2 diabetes are at a normal weight or only moderately overweight," the American Diabetes Association says.
• Eating too much sugar causes diabetes. Fact: Type 1 is genetic and the factors that trigger its onset are not fully understood. Type 2 is caused by genetics and lifestyle factors.
• Diabetics need a special diet. Fact: Healthful eating for diabetics is generally the same as a healthy diet for everyone. Starchy foods are part of a healthy meal plan. The key is portion control.

I didn't receive the mailing of my blood work; it must have got lost in the mail. When I saw the doctor a couple months later for my annual physical, I got it. Normal blood sugar, glucose is 65 to 99 mg/dl. It makes me feel like diabetes is now diagnosed at 100, not 126. I feel like that the medical establishment is shrinking the range of normal so they can put more of us on medication.

Not that it matters, my blood sugar came out at 85. I doubt that prediabetes is a disease, but my paperwork makes it look like the cutoff for diabetes, not prediabetes is 100.